============================================================================= Run Date: JUL 08, 2021 Designation: FB*3.5*184 Package : FB - FEE BASIS Priority: Mandatory Version : 3.5 SEQ #158 Status: Released Compliance Date: AUG 07, 2021 ============================================================================= Associated patches: (v)FB*3.5*179 <<= must be installed BEFORE `FB*3.5*184' (v)FB*3.5*183 <<= must be installed BEFORE `FB*3.5*184' Subject: UPDATE RBRVS FOR CY2021 Category: - Routine - Other Description: ============ Patch FB*3.5*184 addresses the following issue: 1. Updates the Resource Based Relative Value Scale (RBRVS) Fee Schedule with changes for Calendar Year (CY) 2021. Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A Forms Associated: Form Name File Number New/Modified/Deleted --------- ----------- -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- N/A Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- N/A Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A Additional Information: ----------------------- Blood Bank Team Coordination: N/A New Service Requests (NSRs): N/A Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1. INC17168416 - The RBRVS Fee Schedule needs to be updated for the Calendar Year 2021. Problem: -------- The RBRVS Fee Schedule needs to be updated for the Calendar Year 2021. Resolution: ----------- This patch includes the data needed to calculate fee schedule amounts based on the RBRVS (also referred to as Medicare Physician Fee Schedule) for calendar year 2021. The RBRVS fee schedule for future calendar years will be issued by a patch as they become available. The RBRVS fee schedule data is contained in four existing files. These files are all stored in global "^FB". The following 3 files are included in the build of this patch, and will overwrite the current files upon install: FEE BASIS GEOGRAPHIC INDEX (#162.96) file FEE BASIS CPT RVU (#162.97) file FEE BASIS MODIFIER TABLE INDEX (#162.98) file The 4th file listed below will be updated by post install routine FBXIP184: FEE BASIS HCFA CONVERSION (#162.99) file The additional data added by this patch will increase the size of the FB global by approximately 8 MB. Routine FBAAFSR was modified to properly round values to the nearest cent based on 5 decimal places after the dollar to mirror CMS. Installation of this patch will affect the menu options used to enter or edit payments for the Medical Fee program (Outpatient) and Ancillary Payments for the Civil Hospital program. The calendar year 2021 RBRVS fee schedule will be used for payments that have a date of service on or after January 1, 2021. The RBRVS fee schedules for calendar years beginning 1999 through 2020 will be retained in the VISTA database and will continue to be used for payments that have a date of service on or after September 1, 1999 and before January 1, 2021. The 2002 RBRVS fee schedule will be used for any payments entered prior to the installation of this patch that had a date of service on or before March 1, 2003. Existing payments are NOT modified by this patch. The fee schedule amount is only calculated when payments are entered or edited. The PLACE OF SERVICE (POS) code is used to determine if the facility or non-facility practice expense Relative Value Unit (RVU) should be used during RBRVS fee schedule calculations. The list of codes considered facility and non-facility has not changed since 2011. Here are the valid POS codes that are in effect. Codes considered as facility setting - 05,06,07,08,21,22,23,24,26,31,34,41,42,51,52,53,56,61 Codes considered as non-facility setting - 01,03,04,09,11,12,13,14,15,16,17,20,25,32,33,49,50,54, 55,57,60,62,65,71,72,81,99 The following four options are used to enter or edit payments for the Medical Fee (outpatient) program: Enter Payment [FBAA ENTER PAYMENT] Multiple Payment Entry [FBAA MULTIPLE PAYMENT ENTRY] Reimbursement Payment Entry [FBAA MEDICAL REIMBURSEMENT] Edit Payment [FBAA EDIT PAYMENT] The following four options are used to enter or edit ancillary payments for the Civil Hospital program: Ancillary Contract Hosp/CNH Payment [FBCH ANCILLARY PAYMENT] Multiple Ancillary Payments [FBCH MULTIPLE PAYMENTS] Patient Reimbursement for Ancillary [FBCH ANCILLARY REIMBURSEMENT] Services Edit Ancillary Payment [FBCH EDIT ANCILLARY PAYMENT] The following option is used to calculate a fee schedule amount without having to enter a payment: Calculate Payment Amount [FBAA FEE SCHEDULE RATE] Components: ----------- UP SEND DATA USER DATE SEC. COMES SITE RSLV OVER FILE # FILE NAME DD CODE W/FILE DATA PTRS RIDE -------------------------------------------------------------------------- 162.96 FEE BASIS GEOGRAPHIC INDEX NO N0 YES OVER NO NO 162.97 FEE BASIS CPT RVU NO NO YES OVER NO NO 162.98 FEE BASIS MODIFIER TABLE INDEX NO NO YES OVER NO NO Test Sites: ----------- VA North Texas HCS Martinsburg VAMC Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released using a host file. The host file is available at the following location: /srv/vista/patches/SOFTWARE/FB3_5184.KID Documentation Title File Name Format -------------------------------------------------------------------- FB3_5184.KID FB3_5184.KID ASCII Patch Installation: ------------------- Pre/Post Installation Overview: ------------------------------- Pre-Installation Instructions: ------------------------------ This patch may be installed with users on the system; although it is recommended that it be installed during non-peak hours to minimize potential disruption to users. This patch could take up up tp several hours to install, and is recommended to be queued to install during off hours. Installation Instructions: 1. Use the Load a Distribution option contained on the Kernel Installation and Distribution System Menu to load the Host file. When prompted to "Enter a Host File:" enter /srv/vista/patches/SOFTWARE/FB3_5184.KID 2. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, A. Select the Verify Checksums in Transport Global option to confirm the integrity of the routines that are in the transport global. When prompted for the INSTALL NAME enter FB*3.5*184. B. Select the Backup a Transport Global option to create a backup message. You must use this option and specify what to backup; the entire Build or just Routines. The backup message can be used to restore the routines and components of the build to the pre-patch condition. i. At the Installation option menu, select Backup a Transport Global ii. At the Select INSTALL NAME prompt, enter your build FB*3.5*184 iii. When prompted for the following, enter "B" for Build. Select one of the following: B Build R Routines Enter response: Build iv. When prompted "Do you wish to secure your build? NO//", press and take the default response of "NO". v. When prompted with, "Send mail to: Last name, First Name", press to take default recipient. Add any additional recipients. vi. When prompted with "Select basket to send to: IN//", press and take the default IN mailbox or select a different mailbox. vii. Repeat step ii for each build in the host file. C. You may also elect to use the following options: i. Print Transport Global - This option will allow you to view the components of the KIDS build. ii. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when this patch is installed. It compares all of the components of this patch, such as routines, DDs, templates, etc. D. Select the Install Package(s) option and choose the patch to install. i. If prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//', answer NO. ii. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO. iii. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', answer NO Post-Installation Instructions: N/A Back-Out/Roll Back Plan: ------------------------ Prior to installing the updated KIDS package, the site/region should have saved a backup of the routines in a mail message using the Backup a Transport Global [XPD BACKUP] menu option. The message containing the backed up build can be loaded with the "Xtract PackMan" function at the Message Action prompt. The PackMan function INSTALL/CHECK MESSAGE is then used to upload the backed up build onto the VistA system. The Kernel Installation & Distribution System [XPD MAIN] can then be used to install the backup build FB*3.5*184b. Routine Information: ==================== The second line of each of these routines now looks like: ;;3.5;FEE BASIS;**[Patch List]**;JAN 30, 1995;Build 4 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: FBAAFSR Before: B49159717 After: B51102194 **4,53,71,84,92,93,99,102,105, 109,110,112,118,145,179,184** Routine Name: FBXIP184 Before: n/a After: B1848533 **184** Routine list of preceding patches: 179 ============================================================================= User Information: Entered By : Date Entered : MAR 22, 2021 Completed By: Date Completed: JUL 08, 2021 Released By : Date Released : JUL 08, 2021 ============================================================================= Packman Mail Message: ===================== No routines included